{include file="public/nheader" /}
<div class="layui-fluid layui-bg-white">
    <form action="{:url()}" class="layui-form layui-form-fixed">
        <div class="layui-form-item">
            <label class="layui-form-label">
                <font color="red">* </font>赠品名称
            </label>
            <div class="layui-input-block">
                <input type="text" name="title" required="" lay-verify="required" autocomplete="off" class="layui-input"
                    value="{$row.title|default=''}" placeholder="请填写用户名称、备注">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">
                <font color="red">* </font>采购价
            </label>
            <div class="layui-input-block">
                <input type="number" name="total" required="" lay-verify="required" autocomplete="off"
                    class="layui-input" value="{$row.total|default=''}" placeholder="请填写采购价">
            </div>
        </div>
        <div class="layui-footer layui-form-item layui-center ">
            <input type="hidden" value="3" name="type" />
            <input type="hidden" value="{$row['id']|default='0'}" name="id" />
            <button class="layui-btn" lay-filter="submitIframe" type="button" lay-submit>提交</button>
            <button class="layui-btn layui-btn-primary" type="button" sa-event="closeDialog">取消</button>
        </div>
    </form>
</div>
{include file="public/nfooter" /}